Comparison Of The Efficacy Of Urethral Sling Treatment With Self Fascia Or Synthetic Material To Stress Urinary Incontinence

Objective:To compare the efficacy of autologous iliotibial fascial fascia of lateral femoral muscle and synthetic retropubic mid-urethral sling in the treatment of tension urinary incontinence.Method:The clinical data of 92 female patients with stress urinary incontinence treated in The First Bethune Hospital Of Jilin University from January 2016 to January 2019 were analyzed retrospectively.Methods:Depending on the surgical material,92 patients were divided into two groups:the synthetic material group and the autologous fascia group.In the synthetic material group,the tension-free polypropylene mesh tape was used to suspend the middle segment of the pubic urethra(71 cases).In the autologous fascia group,the iliotibial fascia of the lateral femoral muscle was used to suspend the middle segment of the pubic urethra(21 cases).The age of synthetic material group was 56.5±6.9 years,and the course of disease was 8.6±3.5 years.The body mass index(BMI)was 24.7±2.5 kg/m~2.The age of autologous fascia group was56.9±7.3 years,the course of disease was 9.6±4.1 years.The body mass index(BMI)was 24.7±2.4 kg/m~2.The operation time,blood loss during surgery,incidence of postoperative urinary retention,therapeutic effect,incidence of postoperative inguinal pain and hospitalization expenses were compared between the two groups.Result:The incidence of postoperative groin pain in the composite material group was 16.9%,and that in the autologous fascia group was 0.The incidence of postoperative groin pain in the autologous fascia group was lower than that in the composite material group,and the difference was statistically significant.The objective effective rate of the autologous fascia group was 90%,and that of the synthetic material group was 92%.The autologous fascia group was lower than the synthetic material group,but the difference was not statistically significant.There were significant differences in operation time and intraoperative bleeding between the two groups,and the synthetic material group was better than the autologous fascia group.There was significant difference in hospitalization expenses between the two groups,and the cost of autologous fascia group was lower than that of synthetic material group.Conclusion:(1)Autologous fascia sling can achieve the same therapeutic effect as synthetic material sling.(2)Compared with synthetic material sling,autologous fascia sling has the advantages of lower incidence of groin pain,lower incidence of rejection and vaginal erosion and lower hospitalization cost.(3)Compared with synthetic material sling,autologous fascia sling has some disadvantages,such as longer operation time and more blood loss.(4)Autologous fascia sling is still one of the most important surgical methods for stress urinary incontinence.